| NPI | 1356713242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDEY LOCKHART Office Manager 330-963-5905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 30018655) |
| Enumeration Date | 2015-10-30 |
| Last Update Date | 2015-10-30 |